Pain Management Nursing Exam Practice Questions
1. A neuroma is an unusual growth area on a damaged nerve ending that is frequently the site of ectopic impulse generation and mechanosensitivity. Which of the following statements describing neuromas is inaccurate?
a. Neuromas may be very small, making palpation challenging or impossible.
b. Neuromas ensnared in scar tissue may cause continuous activations (neuroma in continuity).
c. Neuromas are unable to form after limb amputations.
d. Neuroma formation may occur on myelinated and unmyelinated nerve fibers.
2. In 2001, the American Nurses Association (ANA) Code for Nurses (Table 12-1) declared that pain management nurses were on the front lines of care for those who are most vulnerable to pain and its undertreatment. According to the ANA, which of the following is not included in creating a caring environment as the cornerstone for effective pain management?
a Continued assessment of the values of the patient, family, and nurse is essential.
b. Understanding what pain means to a patient provides insight on how to intervene.
c. Ethics committees play an important role in ensuring institutional commitment to pain management.
d. Caring implies attaining as much education as possible.
3. Unresolved pain results in the body's stress response and the release of stress hormones. Which of the following conditions occur when pain is unrelieved?
a. increased myocardial oxygen consumption and catabolism
b. bradycardia and fluid retention
c. immunosuppression and increase in deep vein thrombosis
d. a and c
4. Duty is established when a professional relationship is established between the nurse and patient. Which of the following best defines breach of duty?
a. failure to evaluate and report epidural injection for signs of infection
b. failure to report addiction to legal authorities
c. administration of opioids for pain
d. failure to employ staff with pain management background
5. Assessment of acute pain includes determining the location of the pain, a description of the type of pain (in the patient's own words), and an evaluation of the pain intensity and duration. What are some of the tools used to establish the intensity of the pain?
a. Numeric Pain Intensity Scale and Visual Analog Scaleb.
b. McGill Pain Questionnaire
c. Pain Outcomes Questionnaire
d. Brief Pain Inventory
Pain Management Nursing Exam Answer Key
1. C: Neuromas frequently form after limb amputation. They form on damaged myelinated and unmyelinated nerve fibers, and they may be tiny and difficult to palpate. If a neuroma is located inside scar tissue, ongoing stimulation may occur, causing a condition that is referred to as neuromas in continuity.
2. D: Caring implies a commitment to all the bioethical principles (Thompson, 1996). Caring is a willingness to respect the patient's informed choices based on his or her values and beliefs.
3. D: Unresolved pain and the ensuing stress hormone release may cause several negative physical effects, including increased myocardial oxygen consumption, tachycardia, hypercoagulability (leading to increase in deep vein thrombosis), immunosuppression, and unrelenting catabolism. Pain also decreases gastric motility.
4. A: The definition of breach of duty is the failure of the pain management nurse to provide reasonable care. Examples include the failure to observe and report an infection at the site of an epidural injection. Opioid administration is part of the pain management nurse's job. The staff must have ongoing appropriate pain management education. Failure to report significant changes in the patient's condition is a breach of duty.
5. A: The determination of the intensity of acute pain may be accomplished by the use of existing tools. These include the Visual Analog Scale (VAS) and the Numeric Pain Intensity Scale. The McGill Pain Questionnaire measures experimentally induced and postprocedural pain. The Pain Outcomes Questionnaire is used to assess chronic pain. The Brief Pain Inventory (BPI) was developed for patients with cancer pain and is now used in the assessment of other types of chronic pain.
